Organization
COMPLETE FAMILY EYE CARE OPTOMETRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLEG LISITSYN OD (OWNER)
(908) 725-0008
Entity
Organization
Contact information
Practice address
400 COMMONS WAY, SUITE 354, BRIDGEWATER, NJ 08807-3294
(908) 725-0008
(908) 725-0078
Mailing address
400 COMMONS WAY, SUITE 354, BRIDGEWATER, NJ 08807-3294
(908) 725-0008
(908) 725-0078
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00577200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406783
—
NJ
01
—
60098307
HORIZON BCBS
NJ
Enumeration date
03/03/2014
Last updated
01/24/2019
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